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Managing PCOS-Related Infertility: Ovulation Induction, In Vitro Fertilization, and In Vitro Maturation

Chapter

Abstract

Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder that affects up to 15 % of reproductive-age women. One of the hallmarks of the disorder is anovulation, making infertility an area of high concern within this population. Fortunately, there are several treatment options available to assist women with PCOS to achieve a healthy pregnancy. After exclusion of additional contributing factors to the infertility diagnosis, ovulation induction remains the mainstay in the management of PCOS-related infertility. For anovulatory women with excess body mass, weight loss is the most physiologic method to restore ovulatory cycles. When medical intervention is indicated, clomiphene citrate is considered the gold standard modality for ovulation induction, although aromatase inhibitors are increasingly being utilized in recent years. Alternative approaches include ovarian stimulation with the use of gonadotropins, in vitro fertilization (IVF), and, on an individualized basis, in vitro maturation (IVM). In patients with PCOS, the goal of all fertility treatment modalities is to achieve a singleton live birth, while protecting patient safety, limiting the potential risks of multiple pregnancies, and preventing ovarian hyperstimulation syndrome (OHSS).

Keywords

Luteinizing Hormone GnRH Agonist Clomiphene Citrate Ovulation Induction GnRH Antagonist 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology and Reproductive SciencesYale School of MedicineNew HavenUSA

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